CPB Certified Professional Biller Certification Practice Exam

What is the universal claim form used by physicians' offices?

1. Patient Information Form

2. CMS-1500

3. UB-04

4. Health Coverage Report

The correct answer is: CMS-1500

The CMS-1500 form is the universal claim form used by physicians' offices to bill for services provided to patients. This form is specifically designed for outpatient billing, primarily for non-institutional healthcare providers, such as physicians and other healthcare practitioners. It's essential because it allows providers to report a variety of healthcare services, including physician services, therapy services, and diagnostic tests. The standardization of the CMS-1500 form ensures consistency in the information provided to insurance companies, which helps in the processing of claims and ensures that these claims are compliant with payer requirements. In contrast, the other options serve different purposes within the healthcare billing and documentation process. The Patient Information Form is used to gather demographic and insurance information from patients, but it does not serve as a billing claim. The UB-04 form is used for institutional providers, such as hospitals or nursing facilities, and is not appropriate for outpatient physician services. The Health Coverage Report is generally not a recognized universal claim form and does not fulfill the billing requirements for medical services. Thus, the CMS-1500 form stands out as the correct answer for universal claims in this context.